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'A Date.
T 3813
NORTq �
TOWN OF NORTH ANDOVER
49 PERMIT FOR PLUMBING
,SSACHUS�
This certifies that .(
has permission to perform. . . . . . . . .. . . . . . . . . . . . . . .
plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
at.hf* d. . .�Y*-''*. . . . . . . . . . . . . . . .. North Andover, Mass.
V
Fee.��. . .Ltc. No.� A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
PLUMBING INSPECTOR
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer
R.
Date. . �d. . . .
38 .3
' NORTIy TOWN OF NORTH ANDOVER
Ot �.•D
544PERMIT FOR PLUMBING
♦ � •D^�TRD��♦y�
,SSACNUSE�
This certifies that . ..
has permission to perform . . � ! f';`. . . . . . . . . . . . . .
plumbing in the buildings of . ./... . .`.. .. ... . . . . . . . . . . . . . . . . . . . .
at
North Andover, Mass.
a
Fee. ' . . .LicNo.. �- ,6
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
PLUMBING INSPECTOR
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer
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1j, MASSACHUSETTS UNIFORM APPLICATION FOR P RMIT TO DO PLUMBING
Type or print)
NORTH ANDOVER,MASSACHUSETTS f Datuilding Locations Permit #
Amount �J
Owner's Name
New Renovation Replacement Plans Submitted l
FIXTURES
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SLRBM
&�SIIV>tTII'
LSE RDCR
r4)FLOOR
3M Fi"
4113 RDCR
5113 FLOCK
6113 ROCR
7113 FLDCR
sa3xOQt
(Print or type) j / Check one: Certificate
Installing Company Namer Corp.
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Address d d �" � � Partner.
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Business Telephone r U .. C>
C-2 —Firm/Co.
Name of Licensed Plumber: n /,-) "N / q-o zu "0—
Insurance Coverage: Indicate the kype of insurance coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity Bond
Insurance Waiver: 1,the undersigned,have been made aware tlfat the licensee of this application does not have any one of the above
three insurance
Signature Owner Agent 0
S
l�rs�t�acfra>�d�ta�s�i�:�l� la�m�c �-�cmd.acan�a-f9c
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' best of my 1-wMedge and tam Z phmmtimg wain aria itntaBati� �rniea iar be
compliance with all pertinent provisions of the Massachusetts to m e and apter 14 the eral Laws.
By: +gna re o n um er
Type of Plumbing license
Title ( (�
City/Town mer Master Journeyman ❑
APPROVED(OFFICE USE ONLY